• Title/Summary/Keyword: Suicidal

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Clinical Patterns of Penetrating Torso Injury at Emergency Department (응급실을 통하여 입원한 체간부 관통상 환자에 관한 임상적인 고찰)

  • Yun, Soon Young;Cheon, Young Jin;Won, Tae Hee
    • Journal of Trauma and Injury
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    • v.18 no.1
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    • pp.47-52
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    • 2005
  • Background: This study was undertaken to evaluate the clinical pattern of the patients with penetrating torso injury. We retrospectively analyzed the clinical symptoms, mechanism of injury, injury type including injured organ, and ultimate outcome of treatment. Our purpose of the study was to establish guideline of management in penetrating torso injury. Methods: This study consists of an analysis of a consecutive series of 94 patients with penetrating injury of trunk treated at one general hospital during 7year period (from January 1995 to April 2003) who was admitted through in our emergency department. All data were collected from the medical records and entered in a database for analysis on the following: age, sex, mechanism of injury, vital sign at admission, clinical outcome including hospital mortality, length of hospital stay, length of intensive care unit stay, requirement of crystalloid fluid and blood product. Results: Among 94 patients, there were 68 men and 26 women, with ages ranging from 19 to 82 years (average 38.2 years). The most frequent mechanism of injury was violence by others including rob (n=54, 57.4%) followed by suicidal attempt (n=24, 25.5%) and accidental injury (n=16, 17.0%). No injury was inflicted from gun. In 37 patients, systolic blood pressure at admission was under 90mmHg. The time interval from injury to admission, and from admission to operation was 57.8minutes and 4hour 12minutes each. Laparotomy was required in 70 patients, thoracotomy in 5 patients, and 3 patients required thoracotomy and laparotomy. Among 94 patients, an average of 1.7 organs were injured. The small bowel and colon were the organs most commonly wounded followed by liver, mesentery, pleura. Of the 94 patients, 6 died for an overall mortality rate of 6.4%, and two of them were not related with hemorrhage. The average length of hospital stay was 18.1 days, and 40 patients required ICU care. Conclusion: Of the 94 patients who were admitted from penetrating torso injury, no patient was injured from firearm. Overall mortality rate was 6.4%. In our hospital, firearm injury was relative rare.

The Relationship between Psychiatric Consequences and Injury Severity Following Traffic Accidents (교통사고후 외상심각도와 정신과적 증상의 관계)

  • Lee, Moon-In;Park, Sang-Hag;Kim, Sang-Hoon;Kim, Jae-Min;Kim, Hack-Ryul
    • Korean Journal of Psychosomatic Medicine
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    • v.12 no.1
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    • pp.66-75
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    • 2004
  • Objectives: This study was intended to see the relationship between psychiatric consequences and injury severity following traffic accidents. Methods: We surveyed the 134 patients who were hospitalized from 1994 to 2003 at Chosun University Hospital for psychiatic disability evaluation following traffic accident. We reevaluate demographic factors from admission note. Psychiatric symptoms from mental status exam in medical records. Psychological tests(MMPI, BAI, BDI, K-WAIS) were done. Then we calculate the injury severity score and McBride's rate of disability due to diagnosis from emergency care hospital records. Their relationships were evaluated by statistical methods which were t-test and Pearson correlation analysis using SPSS-10. Results: When physical injury was not severe, suicidal attempt was more frequent and depression, hysteria, psychasthenia, psychopathic deviation subscales were high in MMPI. But when physical injury was severe, they have diffficulty in concentration, impaired orientation, and changed in IQ score. There was no relationship between physical injury severity and faking bad scales(F, Ds-r). Conclusion: We must not assume when physical injury was not severe, the severe sympomts are just faking for their benefit.

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Factors Influencing Subjective Sleep Sufficiency among Korean Adolescent by Gender: Based on 2016 12th Korean Youth Risk Behavior Survey (성별에 따른 청소년의 주관적 수면충족감에 영향을 미치는 요인: 2016년 제 12차 청소년건강행태온라인조사를 기반으로)

  • Chae, Myung-Ock
    • Journal of the Korea Academia-Industrial cooperation Society
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    • v.18 no.6
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    • pp.343-355
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    • 2017
  • This study compared the individual, family, environmental factors, and subjective sleep sufficiency according to gender among Korean adolescents and to examine relevance among the individual, family, environmental factors, and subjective sleep sufficiency. The subjects were 65,528 Korean adolescents(male: 33,803, female: 31,725), who were derived from the 12th Korea Youth Risk Behavior Web-based Survey 2016 in South Korea. As a result, the prevalence of the subjective sleep sufficiency in this study was 33.4% male and 19.5% female. The subjective sleep sufficiency was affected by the depression experience, suicidal ideation, school achievement, feeling of stress, feeling of happiness, subjective health status, alcohol experience, smoking experience, substance experience, allergic rhinitis, and atopic dermatitis in individual factors; economic status, educational level of parents and living arrangement in family factors; school grade, school type and emotional support in environmental factors in both males and females. In individual factors, breakfast eating and asthma affected the male's subjective sleep sufficiency and physical activity affected the female's. The mental health of the individual factors was the most influential factor in adolescent's subjective sleep sufficiency. Therefore, nursing intervention to improve Korean adolescent's subjective sleep sufficiency should be applied considering gender differences.

CHARACTERISTICS OF UNRULY & DELINQUENT ADOLESCENTS ADMITTED TO A PSYCHIATRIC INPATIENT UNIT (청소년 병동에 입원한 비행 청소년의 특성에 관한 연구)

  • Lee, Young-Sik;Kim, Wun-Jung;Carey, Michael
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.8 no.1
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    • pp.70-82
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    • 1997
  • Objective:This study was performed to identify and understand the characteristics of adolescents who had a history of police arrest and/or were adjudicated unruly/delinquent by the juvenile court. Method:The study employed a retrospective reivew of coumputer-recorded data set on 210 consecutive admissions to an adolescent psychiatric inpatient unit. Three groups(No Police Contact, N=115;Police Contact Only, N=60;Adjudicated, N=35) were compared on the areas of a) cognitive and educational performance b) emotion:anxiety, depression, suicidality c) personality d) family and life experiences. Standardized assessments were administered to all subjects using WISC-Ⅲ, Kaufman Test of Educational Achievement, Millon Adolescent Personality Inventory, Reynolds Adolescent Depression Scale, Revised-Chilren’s Manifest Anxiety Scale, Suicide Ideation Questionnarie, Suicide Behavior Interive, Life Events Checklist, and Family Environmental Scale. A subgroup of the subjects, 60 cases also received a standardized interview by Child Assessment Schedule. Results:The characteristic findings of the delinquent group(the police contact only and adjudicated subjects combined) included (1) a high rate of adoption, sexual promiscuity, out of home placement, and repeated psychiatric hospitalization, (2) low verbal IQ scores and educational achievements, (3) high impulsivity, low social conformity, and high forcefulness in personality inventory, (4) low activityrecreation orientation and low moral religious emphasis in family environment, (5)a high frequency of adverse life experiences, (6) among 3 groups, the Police Contact Only group showed the lowest depression, anxiety and suicidal ideation scores, (7) a high diagnostic frequency of conduct disorder, ODD, and ADHD. Conclusions:The adolescent psychiatric inpatients with a delinquent history presented with a certain clinical, family, psychometric characteristics that warrant specific clinical intervention strategies for their cognitive deficits, an impulsive personality style, family dysfunction with adverse life experiences and disruptive behavioral disorders, different from the rest of adolescent psychiatric inpatients.

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Prevalence of School Bullying and Related Psychopathology in Children and Adolescents (소아청소년 집단에서 집단 따돌림의 유병률과 이와 관련된 정신병리 현상)

  • Kwon, Soon-Jae;Park, Tae-Won;Park, Seon-Hee;Yang, Jong-Chul;Chung, Young-Chul;Chung, Sang-Keun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.23 no.3
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    • pp.143-153
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    • 2012
  • Objectives : This study examined the current prevalence rate of school bullying and its related psychopathology. Methods : A total of 3,550 elementary/middle school students and their parents were recruited for this study. A self-report questionnaire on perpetration and victimization in school bullying was used for collection of data regarding prevalence and the present state of school bullying. For evaluation of associated psychopathology, self report forms, including the Children's Depression Inventory (CDI), State-Trait Anxiety Inventory for Children (STAIC), attention-deficit hyperactivity disorder Rating Scale (ARS), Korean-Child Behavior Checklist (K-CBCL), Korean-Youth Self Report (K-YSR), and the Korean Eppendorf Schizophrenia Inventory (K-ESI) were applied. Samples were classified according to four subtype groups (control, victim, perpetrator, and victim-perpetrator) and characteristics of each group were compared. Results : Overall, the prevalence rate for bullying perpetration was 64.4% and the prevalence rate for bullying victimization was 63.4%, indicating involvement of more than half of students in school bullying. Bully-victims reported high social immaturity and depressive and suicidal tendency, whereas bully-perpetrators reported less social immaturity and more externalizing problems. Among the subtype groups, the victim-perpetrator group showed the most prominent depressive/anxiety tendency and behavioral problems. Conclusions : Both victimization and perpetration of bullying are common problems for child and adolescent groups and several psycho-social problems were found to be related. The results of this study will guide direction of future study and development of strategies for prevention of bullying.

The Effectiveness of Mental Health Problems Screening and Treatment Linkage in Children & Adolescents : Community Based Study Focused on ADHD and Depression (소아 청소년 정신건강 선별검사 및 치료 연계 효율성에 대한 연구 : 지역사회 중심 연구)

  • Kim, Hyo-Jin;Cho, Soo-Churl;Kim, Jae-Won;Kang, Je-Wook;Shin, Min-Sup;Kim, Hyo-Won;Yun, Myung-Ju;Lee, Kyong-Young;Kang, Yun-Ju;Kim, Boong-Nyun
    • Journal of the Korean Academy of Child and Adolescent Psychiatry
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    • v.20 no.3
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    • pp.129-139
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    • 2009
  • Objectives : This study evaluated the effectiveness of school-based mental health screening and treatment linkage programs, focusing on attention-deficit hyperactivity disorder (ADHD) and adolescent depression. Methods : All 11,158 children and adolescents aged 8-14 years in Seoul received a school-based mental health screening, consisting of the Korean versions of the ADHD rating scale and the Child Behavior Checklist (CBCL), for ADHD, and the Center for Epidemiological Studies Depression Scale (CES-DS) and the Suicidal Ideation Questionnaire-Junior (SIQ-JR), for depression. The high-risk children's and adolescents' diagnoses were confirmed using the Diagnostic Interview Schedule for Children-IV (DISC-IV). Treatment linkage programs were managed by the Seoul Metropolitan Community Mental Health Center (Program 1), the Seoul Metropolitan Office of Education (Program 2), or the Dongjak District Office of Education (Program 3). We estimated and compared the referral rates of the three programs. Results : Program 1 screened and referred 22.9% of ADHD youths to mental health services, Program 2, 68.8%, and Program 3, 40.0%. Program 1 screened and referred 22.8% of depressed youths to mental health services, Program 2, 53.8%, and Program 3, 88.9%. Key elements for successful screening and referral programs were an effective school/community mental health center/Office of Education network, the parents' financial support and perception of their child's mental health status as being problematic, and the teachers' active engagement. Conclusion : This is the first study investigating the effectiveness of school-based mental health screenings' linkage to treatment for primary and middle school students in Korea. An effective network for community mental health and improvements in parents' and teachers' perceptions regarding mental health are needed for more successful treatment linkage.

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Effect of the Spportive Project for the Priority Region of Educational Welfare Investment[SPPREWI] on School Children's Psychosocial and Cognitive Adjustment (교육복지투자우선지역 지원사업이 아동.청소년의 사회.정서 및 인지적 발달에 미치는 효과)

  • Jung, Yeon-Jung;Um, Mung-Yong
    • Korean Journal of Social Welfare
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    • v.61 no.4
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    • pp.5-33
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    • 2009
  • This study attempted to evaluate the effectiveness of the Supportive Project for the Priority Region of Educational Welfare Investment(SPPREWI) which has been put into action in Korea as a part of national policies for poor school children. In so doing this study aimed to test SPPREWI's legitimacy as well as whether we have to continue this program or not. In order to fulfill this research purpose researchers identified several outcome indicators of SPPREWI, which represent psychosocial and cognitive adjustment. The variables pertaining to psychosocial adjustment domain are: self-concept; depression, anxiety, and suicidal impulse; inclination of assault and indignation; delinquency; school life adjustment; and change in social relations. The variables of cognitive adjustment include recognition of self-control in learning; control strategy of learning behavior; and preparedness for job hunting. In this study the quasi-experimental group contained students from schools which are under the SPPREWI. The control group was composed of students from schools which were free from SPPREWI but under the influence of deteriorating school environment. The quasi-experimental group and the control group were compared in terms of outcome indicators presented earlier. Within the quasi-experimental group both the students below poverty-line and the students above poverty-line were divided into two groups each by the level of service use, and were compared in terms of the outcome variables presented earlier. Study results supported the argument that SPPREWI was effective generally in improving students' school adjustment. Study results also showed that the variable of 'school nurturance' played a significant role in moderating the effect of SPPREWI on a couple of outcome variables specially when schools' overall educational environment was in poor condition. Implication as well as suggestion were presented on the basis of study findings.

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A Study On Subjective Experience Of Drug Abuse Adolescent (약물남용 청소년의 주관적 경험에 관한 연구)

  • 김미희
    • Journal of Korean Academy of Nursing
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    • v.30 no.1
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    • pp.7-17
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    • 2000
  • The purpose of this study is to affect health improvement of adolescent, to understand behavioral causes follow adolescent's drug abuse, to understand recovery and rehabilitaton process of adolescent drug abuser. The data are collected through open questionnaire and interview of 25 adolescents from the experienced drug abuse 16 students(male 8, female 8) in two vocational high schools and admissing adolescents 9 person in Alcohol-Drug Addiction Care Centre in Seoul from June 28th to August 31st, 1994. The collected data are arranged and explained through categorizing method stated contents about motives, causes, experiences and effected behaviors for using the drugs of drug abuser adolescents. DRUG USING MOTIVATION They are almost first son and daughter in their family. In their conversation person, male converses to their mother well, but female does not converse to their parents include family. Both groups respond positively to companionship and attitude to other, but negatively to self-confidence and actualizing attitude. They hope always peace of family and want to do their best for their life. In school group, hard and difficult things are school life and family problems, also using the drugs for resolving the them. About drug using behaviors, male responds to bad habbit and shamfull, but female is unconcerned with drug using attitude. The first background of drug using, male gets to use because of curiosity and to be induced from friends or seniors, but female gets to use for feminine beauty(thin body) and escape from reality. Used the drugs, male uses frequently Bond, Butane-Gas among inhalation materials and also marijuana, but female uses various diuretics. The times of drug using, both groups repond to use during the chaging of emotion or filling with stress. The place of drug using, both groups take drugs in vacant houses or in the mountain. The frequency of drug using, they use almost once in a day and they use mostly alone or drug user in friends. Experienced mental changing after drug using, which is fantasy, ecstasy, anxiety and suicidal feeling, and experienced physical changing after drug using, which is elevating sense, headach, abdominal pain, dyspnea and chaging of skin colour and reddish. They coincide with inconvenience feeling due to drug using. RECOVERY AND REHABILITATION PROCESS OF DRUG USING ADOLESCENTS The reason for reforming drug using behavior and attitude, both groups respond to reforming for oneself and social life. The difficult things during the stop to using drugs, all of them responed to family problems, friends problems and temptation and impulse. As for stop to using drug, they need good advise, understandable attitude and family love. But they do not need to be stigmatized, scolding, over protect and ridicule of friends. Also they entreat continuous understanding, advise, concern and the method for resolving stress. For the friends to want to use the drug, they will talk about the stories of their personal experiences and for the friends to stop to using the drug, they will consider for them how to stop. From the theses results, drug users understand personal problems due to drug using, and consider about why to stop and how to stop. Also drug users need to resolve the family problems, personal problems, stress and temptations or impulses. Accordingly this paper suggests that drug users in adolescents need understandable and acceptable atitudes, loving and tenderness, continuous advice and concern, and hopes for life.

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Evaluation of Drugs for Suicide Attempt and Antidote Uses in Emergency Room of a Hospital in Korea (응급실 내원한 자살 시도 환자의 자살시도용 약물 및 해독제 사용 현황에 대한 평가)

  • Lee, Ok Sang;Cheon, Young Ju;Kim, Jung Tae;Lim, Sung Cil
    • Korean Journal of Clinical Pharmacy
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    • v.22 no.4
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    • pp.304-315
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    • 2012
  • Today, suicide by self-poisoning of prescribed or non-prescribed drugs on purpose has been increasing and is a major cause of mortality. It is very important to treat promptly and properly for saving the lives from those suicides. There is neither an organization such as poison control center nor measurement in S. Korea, though. The object of this study was to evaluate information of frequently used substances for suicide attempt in S. Korea. Our results also can provide healthcare provider including pharmacists and doctors, etc and contribute to increasing health and welfare for Korean. From June $1^{st}$ 2006 to April $30^{th}$ 2012, we retrospectively studied patients visiting emergency room due to suicide attempt. We collected information of underlying disease, history of past medical condition and suicide attempt, ingredient and getting route of ingesting substances, emergency treatment, and outcome by reviewing electronic medical record. We also evaluated actual treatment of self-poisoning and made guide information about antidote medication for S. Korean healthcare provider. Among total 242 cases of suicidal attempts, cases ingesting substances including prescription, non-prescription drugs and agricultural chemicals were 86.4%. The most frequently used drugs for suicide attempt were sedatives-hypnotics (53.6%), followed by analgesics (16.7%) and antidepressants (12.4%). Analgesics including acetaminophen and aspirin were most in teenagers but sedatives-hypnotics including benzodiazepines, non-benzodiazepine (zolpidem) and antihistamine were most in other ages including elderly people. Most frequently used antidote was activated charcoal (62.7%) and specific antidotes for some substances (acetaminophen, aspirin, agricultural chemicals) were also treated properly, accompanying with medication for supportive care. In conclusion, the most used substances for suicide attempt were sedatives-hypnotics and treatments for self-poisoning in emergency room were appropriate based on existing references. Therefore, information of frequently used substances and antidote reflecting these results will be useful for South Korean healthcare provider.

Association of Plasma Levels of Angiotensin-Converting Enzyme and Cytokines with Recurrent Depression : A Preliminary Study (안지오텐신전환효소 및 사이토카인 혈장 레벨과 재발성 우울증의 연관성 : 예비 연구)

  • Sohn, Hoyoung;Lee, Sun-Woo;Kim, Min-Kyoung;Lee, Kang Soo;Lee, Sang-Hyuk;Kwon, Min-Soo;Kim, Borah
    • Korean Journal of Biological Psychiatry
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    • v.24 no.1
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    • pp.39-44
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    • 2017
  • Objectives Angiotensin-converting enzyme (ACE) gene and plasma levels of cytokines, such as tumor necrosis $factor-{\alpha}$ ($TNF-{\alpha}$), interleukin-4 (IL-4), interleukin-6 (IL-6), interleukin-10 (IL-10), have previously been determined to be associated with depression. The purpose of this study was to investigate the association of plasma levels of ACE and cytokines with recurrent depression. Methods A total of 52 participants (14 male, 38 female, aged $43.9{\pm}14.0years$) were enrolled after being diagnosed with depression by experienced psychiatrists using the Mini International Neuropsychiatric Interview from the outpatient clinic of the Department of Psychiatry, CHA Bundang Medical Center. The participants completed blood sampling, the Hamilton Depression Rating Scale (HAMD), the Beck Depression Inventory, the Beck Anxiety Inventory, and the Scale for Suicidal Ideation. Results ACE plasma levels are higher in patients with recurrent depression ($27.4{\pm}10.4U/L$) than in patients with newly diagnosed depression ($19.1{\pm}7.7U/L$) (p = 0.004). The levels of cytokines, such as $TNF-{\alpha}$, IL-4, IL-6, IL-10, are not significantly different between the two groups. Additionally, the ACE plasma level is negatively correlated with a reduction in the HAMD over six weeks (r = -0.429, p = 0.046, n = 22). Conclusions The current findings show that plasma ACE levels may be associated with recurrent depression and further suggest that the renin-angiotensin system could play a role in recurrent depression.